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DAPT Duration

Abstract

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Conceptual Framework for Addressing Residual Atherosclerotic Cardiovascular Disease Risk in the Era of Precision Medicine Extended antiplatelet therapy with clopidogrel alone versus clopidogrel plus aspirin after completion of 9- to 12-month dual antiplatelet therapy for acute coronary syndrome patients with both high bleeding and ischemic risk. Rationale and design of the OPT-BIRISK double-blinded, placebo-controlled randomized trial P2Y12 Inhibitor Monotherapy with Clopidogrel Versus Ticagrelor in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention Outcomes in patients treated with ticagrelor or clopidogrel after acute myocardial infarction: experiences from SWEDEHEART registry Dual-antiplatelet treatment beyond 1 year after drug-eluting stent implantation (ARCTIC-Interruption): a randomised trial Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting: a randomized multicenter trial Twelve or 30 months of dual antiplatelet therapy after drug-eluting stents A randomized comparison of Coronary Stents according to Short or Prolonged durations of Dual Antiplatelet Therapy in patients with Acute Coronary Syndromes: a pre-specified analysis of the SMART-DATE trial
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Original Research2018 Jan 14;39(3):181-183.

JOURNAL：Eur Heart J. Article Link

Dual antiplatelet therapy: how, how long, and in which patients?

Lüscher TF. Keywords: Dual antiplatelet therapy

ABSTRACT

Thrombus formation is a crucial event in acute coronary syndromes, bypass occlusion, and stent thrombosis. In the coronary circulation, platelet activation is an initial event,while expression of tissue factor and subsequent activation of the coagulation cascade and invading white blood cells solidify the evolving clot, an event that often leads to vascular occlusion. Platelets are primarily activated by thromboxane and ADP via thromboxane and P2Y12 receptors on the platelet surface that eventually lead to the expression of the glycoprotein IIB/IIIA receptor that binds fibrin. Twenty-one years ago, the first randomized clinical trial established the superiority of dual antiplatelet therapy over anticoagulant therapy among patients undergoing percutaneous coronary intervention. Thus, dual antiplatelet therapy has become a crucial therapeutic intervention in patients with stable or acute coronary artery disease.

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